| NPI | 1962615781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00147000) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010772) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-10-15 |